Assisted Reproductive Technologies for Women with Polycystic Ovarian Syndrome

Abstract

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory fertility problems in women of reproductive age, with a prevalence as high as 40% to 75%. There are different treatment modalities for increasing the chance of pregnancy in PCOS patients. Since most of the PCOS patients suffer from ovulatory problems, therapeutic efforts are focused mainly towards restoring normal ovulation. However, even after pharmacological interventions to ameliorate ovulatory irregularities, women with polycystic ovary are still at high risk of fetal loss. Thus, assisted reproductive techniques (ARTs) have become popular approaches which significantly increase the chances of successful pregnancy in these women, bypassing the conditions of PCOS. The present mini-review ‘pinpoints’ on the suitability of ARTs for PCOS patients who fail to ovulate following the conventional infertility treatment. The article also briefly explains how intracytoplasmic sperm injection (ICSI), the most effectiveART, correlates with better biological parameters, fertilization rate and better quality of embryos in PCOS women.

Polycystic ovary syndrome (PCOS) and oxidative stress

“…These immature follicles become the emblematic tiny cysts observed via ultrasonography, providing the ovaries their 'polycystic' nomenclature. 5,16…”

“…71 Notably, OS stands out as a crucial factor that intensifies the reproductive abnormalities in PCOS. 6,16,72 Studies have shown that the ovaries of individuals with PCOS exhibit increased generation of ROS. 67 Under normal conditions, ROS are counteracted by antioxidant defenses to ensure cellular equilibrium.…”

Primer on Female Infertility for the Reproductive Urologist

“… 7 It has been suggested that oocytes retrieved from polycystic ovaries have an abnormal zone pellucida structure, which can lead to decreased fertilization rates; therefore, intracytoplasmic sperm injection (ICSI) may increase fertilization rates in eggs retrieved from women with PCOS. 8 …”

Role of anti-Mullerian hormone in polycystic ovary syndrome

“…The disease is mainly characterized by an excess availability of androgen and ovarian dysfunctions [4]. Several research articles indicate that PCOS is the most common endocrine and metabolic disorder in women of reproductive age [5][6][7]. The presence of any two of the conditions, i.e., the presence of oligo or anovulation, clinical or biochemical androgen excess or polycystic ovarian morphology detected by ultrasonography can be used as an identifying tool for the diagnosis of PCOS [8].…”